Frameworks of care for persons with dementia and their relationship with the material environment of nursing homes

During the past half of a century, there is a paradigm shift in the care for persons with dementia. In 1970-1980 the traditional medical-somatic approach, started to get complemented with more psychosocial approaches. These first models emphasized the role of the social and material environment for compensating for the cognitive and functional losses in dementia. At the end of the 1980s and in the 1990s attention shifted towards the individual experiences and ways of coping with dementia, with emotion-oriented care, validation and reminiscence as important care models. From 2000 on, we see that these psychological models are further refined by taking also the material environment as important therapeutic feature for guiding persons with dementia. The growth of homelike, small-scale living units is exemplary of this evolution. After presenting a short overview of these different frameworks and models for care of persons with dementia, we present the results of our empirical research. This research consists of two parts. First, we investigated two case studies of residential care facilities and analysed how their care vision is expressed, directly and indirectly through an open interview about the building process of the nursing home. Second, we performed a survey among directors and care workers of dementia care units in nursing homes in Flanders. The survey intended to measure the vision and attitudes towards optimal care for persons with dementia. The analysed material raises several questions for further reflection. - What are the benefits and pitfalls of the different methods used for investigating the underlying frameworks of care for persons with dementia? - How does the care vision relate to the design and use of the material environment of dementia care units in nursing homes? - In what way should architects be aware of the underlying care vision of nursing home directors in order to create an optimal material environment? How can this be discussed?status: publishe